Battle Creek Hardware Inc.
CREDIT APPLICATION
Legal Name (Number Company Name)______________________________________ In Business Since____________
GST # __________________________________ Business Permit #________________________________
Trade Name _______________________________________________________________________________________________________
Address___________________________________________________________________________________________________________
City __________________________________ Prov/State __________________________Zip/Postal Code ___________________________
Telephone ________________________ Fax _______________________________
Email______________________________________________ Web Site___________________________________________________
Principles
Name __________________________ Title ______________________________________
Name __________________________ Title ______________________________________
Bank _________________________________________ Branch _____________________________________________________
Telephone No _________________________________ Account No _________________________________________________
CREDIT REFERENCES (Suppliers Presently Extending Credit to You. Preferably Local References)
1) _____________________________________ Tele ______________________________ Contact ____________________________
2) _____________________________________ Tele ______________________________ Contact ____________________________
3) _____________________________________ Tele ______________________________ Contact ____________________________
Please note:
The applicant is aware and fully understands that:
a) Charges are due upon receipt of our invoice and are past due thirty (30) days there after. Outstanding balances are subject to charges of 2% per month (24%) per year.
b) Past due accounts are subject to cancellation without notice and third party collection action.
c) All charges must be paid before any claims can be processed.
Signed: ________________________________ Date ________________________________________
Battle Creek Hardware inc. 2461 Hwy 5, Troy, Ontario, Canada L0R 2B0
Tel 519-647-2374 Fax 519-647-3801
www.battlecreekhardware.com bchi@battlecreekhardware.com
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